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狼疮性肠炎的临床特征:一项单中心回顾性研究。

Clinical features of lupus enteritis: a single-center retrospective study.

机构信息

Department of Rheumatology and Immunology, Suining Central Hospital, No.127, West Desheng Rd., Chuanshan District, Suining, Sichuan Province, China.

Department of Scientific Research Management, Suining Central Hospital, No.127, West Desheng Rd., Chuanshan District, Suining, Sichuan Province, China.

出版信息

Orphanet J Rare Dis. 2021 Sep 26;16(1):396. doi: 10.1186/s13023-021-02044-4.

Abstract

BACKGROUND

Lupus enteritis (LEn) is a rare complication of systemic lupus erythematosus (SLE). Timely diagnosis and treatment of LEn are necessary to prevent the most serious consequences - intestinal perforation, gastrointestinal bleeding, and death. We compared the clinical features of SLE patients with and without LEn.

METHODS

The clinical data of LEn inpatients at Suining Central Hospital from July 2012 to June 2020 were examined. These LEn patients were matched (1:2 ratio) with concurrently hospitalized SLE patients who did not have LEn. The two groups were compared using multivariate logistic regression.

RESULTS

We compared SLE inpatients with LEn (n = 43) and SLE inpatients without LEn (n = 86) at our institution. Multivariate logistic regression showed that ascites (odds ratio [OR]: 9.961, 95%CI: 2.215-44.802, P = 0.003), hydronephrosis (OR: 28.060, 95%CI: 2.303-341.962, P = 0.009), leukopenia (OR: 5.890, 95%CI: 1.813-19.135, P = 0.003), reduced complement C3 level (OR: 4.791, 95%CI: 1.605-14.300, P = 0.005), and elevated immunoglobin (Ig)A level (OR: 4.040, 95%CI: 1.307-12.487, P = 0.015) were independently associated with LEn. Within the LEn group, abdominal pain was the most common abdominal symptom (88.4%), and increased mesenteric fat attenuation (74.4%) and bowel wall thickening (58.1%) were the most common computed tomography (CT) findings. Most LEn patients (88.4%) required high-dose glucocorticoid therapy (≥ 80 mg methylprednisolone/day), and cyclophosphamide was the most commonly used immunosuppressant (62.8%).

CONCLUSIONS

Abdominal pain was the most common clinical symptom of LEn. Abdominal CT provides important information for detection and diagnosis of LEn. Ascites, hydronephrosis, leukopenia, hypocomplementemia (C3), and increased IgA were independently associated with LEn.

摘要

背景

狼疮性肠炎(LEn)是系统性红斑狼疮(SLE)的一种罕见并发症。及时诊断和治疗 LEn 对于预防最严重的后果——肠穿孔、胃肠道出血和死亡是必要的。我们比较了狼疮性肠炎患者和无狼疮性肠炎患者的临床特征。

方法

对 2012 年 7 月至 2020 年 6 月遂宁中心医院住院的狼疮性肠炎患者的临床资料进行了检查。这些狼疮性肠炎患者与同时住院的无狼疮性肠炎的狼疮患者(1:2 比例)进行了匹配。使用多变量逻辑回归对两组进行了比较。

结果

我们比较了我院狼疮性肠炎患者(n=43)和狼疮性肠炎患者(n=86)。多变量逻辑回归显示腹水(比值比[OR]:9.961,95%可信区间:2.215-44.802,P=0.003)、肾积水(OR:28.060,95%可信区间:2.303-341.962,P=0.009)、白细胞减少症(OR:5.890,95%可信区间:1.813-19.135,P=0.003)、补体 C3 水平降低(OR:4.791,95%可信区间:1.605-14.300,P=0.005)和免疫球蛋白(Ig)A 水平升高(OR:4.040,95%可信区间:1.307-12.487,P=0.015)与 LEn 独立相关。在 LEn 组中,腹痛是最常见的腹部症状(88.4%),肠系膜脂肪衰减增加(74.4%)和肠壁增厚(58.1%)是最常见的 CT 发现。大多数 LEn 患者(88.4%)需要高剂量糖皮质激素治疗(≥80mg 甲基强的松龙/天),环磷酰胺是最常用的免疫抑制剂(62.8%)。

结论

腹痛是 LEn 最常见的临床症状。腹部 CT 为 LEn 的检测和诊断提供了重要信息。腹水、肾积水、白细胞减少症、低补体血症(C3)和 IgA 升高与 LEn 独立相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8bd7/8474739/111f927ca219/13023_2021_2044_Fig1_HTML.jpg

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